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COVID-19 pandemic has heavily burdened healthcare systems throughout the world, causing substantial mental distress to medical professionals. We aim to investigate the associated traumatic stress in a sample of practicing physicians in Egypt during the COVID-19 pandemic. This cross-sectional study assessed depression, and Post-traumatic stress disorder (PTSD) among a sample of Egyptian physicians using an electronic survey. It included demographic and practice-related data, PTSD Checklist - Civilian Version (PCL-C) and the nine-item Patient Health Questionnaire (PHQ-9). Of the 124 respondents, 66.9% were at high risk for depression and 37.9% met criteria for diagnosis of PTSD. Female gender and perceived work-related stress were significantly associated with PTSD. PTSD and depression severity scores were positively correlated. These findings highlight the importance of timely mental support and intervention for medical workers.

Purpose: To explore the possible challenges and difficulties of using Personal Protective Equipment (PPE) in ophthalmic practice during the Coronavirus disease 2019 (COVID-19) pandemic. Methods: This is a multicenter, international survey among practicing ophthalmologists across different countries. The survey was conducted from September 9th to October 24th, 2020. It included a total of 23 questions that navigated through the currently adopted recommendations in different clinical situations. The survey also assessed the convenience of using various PPE in ophthalmic practice and addressed the clarity of the examination field while using various PPE during clinical or surgical procedures. Results: One hundred and seventy-two ophthalmologists completed the survey (101 from Egypt, 50 from the USA, and 21 from four other countries). The analysis of the responses showed that most ophthalmologists use face masks without significant problems during their examinations, while face shields followed by protective goggles were the most inconvenient PPE in the current ophthalmic practice. Moreover, most of the participants (133, 77.3%) noticed an increase in their examination time when using PPE. Furthermore, a considerable percentage of the respondents (70, 40.7%) stopped using one or more of the PPE due to inconvenience or discomfort. Conclusions: Due to the unique nature of the ophthalmic examination, certain PPE are not ophthalmologist-friendly. Innovative PPE should be tailored for prompt, more convenient, and clearer ophthalmological practice.

Variable models of care have been adopted in different countries in response to the COVID-19 pandemic. Egypt has assigned certain hospitals specifically for the quarantine of COVID-19 patients, where operational medical teams work continuously for 14 days, after which they are released for self-isolation at home for a similar period.The study aimed to evaluate and compare perceived adverse psychological symptoms (stress, anxiety, depression), and insomnia by health-care professionals working in quarantine and non-quarantine hospitals during the COVID-19 pandemic in Egypt, and to explore associated factors with adverse psychological symptoms and insomnia.An online cross-sectional survey was performed in April 2020, using a snowball sampling method. Sociodemographic information perceived general health, healthy lifestyle, insomnia (using Insomnia Severity Index), adverse psychological symptoms (using the Depression, Anxiety and Stress Scale-21), worries and concerns about COVID-19, future perspective about COVID-19, and coping strategies were collected.Five hundred and forty health-care professionals participated; 10.2% (n=55) worked in quarantine hospitals. Younger age (ORa=0.96, 95% CI:0.93-0.99, ORa=0.95; 95% CI:0.92-0.97; ORa=0.96 CI:0.93-0.99), being not ready/sure of readiness to work in quarantine hospital (ORa=1.91, 95% CI:1.22-3.00; ORa=2.01, 95% CI:1.28-3.15; ORa=1.91, 95% CI:1.22-2.98), and insomnia (ORa=5.22, 95% CI:3.38-8.05; ORa=7.58, 95% CI:4.91-11.68; ORa=6.38 95% CI:4.19-9.73) significantly predicted stress, depression and anxiety, respectively. Being female (ORa=1.59, 95% CI:1.04-2.42; ORa=2.09, 95% CI:1.38-3.16) could also significantly predict stress and anxiety.Female and younger age health care professionals were more prone to report adverse psychological symptoms. More and earlier screening for health-care professionals dealing with COVID-19, in addition to providing psychological support, is highly encouraged.حالة الصحة النفسية للمهنيين في مجال الرعاية الصحية العاملين في مستشفيات الحجر الصحي وغيرها في مصر أثناء جائحة كوفيد-19.نجلاء يوسف، آية مصطفى، ريم عزت، مصطفى يوسف، محمد القصاص.اعتُمدت نماذج متغيرة للرعاية في مختلف البلدان استجابةً لجائحة كوفيد-19. وحددت مصر بعض المستشفيات خصيصاً للحجر الصحي لمرضى كوفيد-19، حيث تعمل الأفرقة الطبية العاملة بشكل متواصل لمدة 14 يوماً، ثُم تغادر المستشفيات لتمكث في العزل الذاتي في المنزل لمدة مماثلة.كانت الدراسة تهدف إلى تقييم الأعراض النفسية المتصورة ومقارنتها (الإجهاد، والقلق، والاكتئاب)، والأرق الذي يعاني منه المهنيون في مجال الرعاية الصحية العاملون في مستشفيات الحجر الصحي وغيرها أثناء جائحة كوفيد-19 في مصر، وإلى تحري العوامل المقترنة بالأعراض النفسية والأرق.أُجري مسح إلكتروني مُستعرض في نيسان/أبريل 2020، باستخدام أسلوب كرة الثلج لأخذ العينات. وجُعت معلومات اجتماعية-ديموغرافية، ومعلومات عن الصحة العامة المتصورة، ونمط الحياة الصحي، والأرق (باستخدام مؤشر شدة الأرق)، والأعراض النفسية (باستخدام مقياس الاكتئاب والقلق والإجهاد-21)، وأوجه القلق والمخاوف بشأن كوفيد-19، والمنظور المستقبلي حول كوفيد-19، واستراتيجيات التأقلم.شارك 540 مهنياً في مجال الرعاية الصحية؛ 10.2٪ منهم (العدد=55) عملوا في مستشفيات الحجر الصحي. وأنبأ بشكل كبير عن الإجهاد، والاكتئاب، والقلق على التوالي كلٌ من السن الأصغر (نسبة الأرجحية المُصحَّحة=0.96، 95 ٪، فاصل الثقة: 0.93-0.99، نسبة الأرجحية المُصحَّحة=0.95؛ 95٪، فاصل الثقة: 0.92-0.97؛ نسبة الأرجحية المُصحَّحة=0.96، فاصل الثقة: 0.93-0.99)، وعدم الاستعداد/التأكد من الاستعداد للعمل في أحد مستشفيات الحجر الصحي (نسبة الأرجحية المُصحَّحة=1.91، 95٪، فاصل الثقة: 1.22-3.00؛ نسبة الأرجحية المُصحَّحة=2.01، 95٪، فاصل الثقة: 1.28-3.15؛ نسبة الأرجحية المُصحَّحة=1.91، 95٪، فاصل الثقة: 1.22-2.98)، والأرق (نسبة الأرجحية المُصحَّحة=5.22، 95٪، فاصل الثقة: 3.38-8.05؛ نسبة الأرجحية المُصحَّحة=7.58، 95٪، فاصل الثقة: 4.91-11.68؛ نسبة الأرجحية المُصحَّحة=6.38، 95٪، فاصل الثقة: 4.19-9.73). كما يمكن أن ينبئ أيضاً بشكل كبير عن الإجهاد والقلق كَون العاملين من الإناث (نسبة الأرجحية المُصحَّحة=1.59، 95٪، فاصل الثقة: 1.04-2.42؛ نسبة الأرجحية المُصحَّحة=2.09، 95٪، فاصل الثقة: 1.38-3.16).كان المهنيون في مجال الرعاية الصحية من الإناث والأصغر سناً أكثر عُرضة للإبلاغ عن الأعراض النفسية. ويُشَجع بدرجة كبيرة على إجراء مزيد من التحري والتحري المبكر للمهنيين في مجال الرعاية الصحية الذين يتعاملون مع مرض كوفيد-19، بالإضافة إلى تقديم الدعم النفسي لهم.État de santé mentale des professionnels de santé travaillant dans les hôpitaux égyptiens dédiés ou non à la quarantaine pendant la pandémie de COVID‐19.Des modèles de soins variables ont été adoptés dans différents pays pour riposter à la pandémie de COVID-19. L’Égypte a affecté certains hôpitaux spécifiquement à la quarantaine des patients atteints de COVID-19, où les membres des équipes médicales opérationnelles travaillent en continu pendant 14 jours, après quoi ils sont libérés pour s’isoler à domicile pendant une période similaire.L'étude visait à évaluer et à comparer les symptômes psychologiques perçus (stress, anxiété, dépression) et l'insomnie par les professionnels de santé travaillant dans des hôpitaux dédiés ou non à la quarantaine pendant la pandémie de COVID-19 en Égypte, et à examiner les facteurs associés aux symptômes psychologiques et à l'insomnie.Une enquête transversale a été réalisée en ligne en avril 2020, en recourant à un échantillonnage boule de neige. Des données sociodémographiques, des informations concernant la santé générale perçue, un mode de vie sain, l’insomnie (au moyen de l’indice de gravité de l’insomnie), les symptômes psychologiques (au moyen de l’échelle Depression, Anxiety and Stress Scale-21), les inquiétudes et les préoccupations à propos de la COVID-19, la perspective future vis-à-vis de la COVID-19 et les stratégies d’adaptation ont été recueillies.Cinq cent quarante professionnels de santé ont participé à l’étude ; 10,2 % (n=55) travaillaient dans des hôpitaux dédiés à la quarantaine. Le jeune âge (ORa=0,96, IC à 95 % : 0,93-0,99, ORa=0,95, IC à 95 % : 0,92-0,97 ; ORa=0,96, IC à 95 % : 0,93-0,99), le fait de ne pas être prêt/certain de pouvoir travailler dans un hôpital dédié à la quarantaine (ORa=1,91, IC à 95 % : 1,22-3,00 ; ORa=2,01, IC à 95 % : 1,28-3,15 ; ORa=1,91, IC à 95 % : 1,22-2,98) et l'insomnie (ORa=5,22, IC à 95 % : 3,38-8,05; ORa=7,58, IC à 95 % : 4,91-11,68; ORa=6,38, IC à 95 % : 4,19-9,73) ont permis de prédire de manière significative le stress, la dépression et l'anxiété, respectivement. L’appartenance au sexe féminin (ORa=1,59, IC à 95 % : 1,04-2,42 ; ORa=2,09, IC à 95 % : 1,38-3,16) pourrait également prédire de manière significative le stress et l’anxiété.Les professionnels de santé de sexe féminin et plus jeunes étaient plus enclins à signaler des symptômes psychologiques. Un dépistage plus précoce et plus poussé des professionnels de santé confrontés à la COVID-19 ainsi qu’un soutien psychologique, sont vivement encouragés.

Objective We aimed to explore compliance with and barriers to wearing facemasks at the workplace among university teaching staff in Egypt. Methods An online survey was shared with teaching staff members at 11 public and 12 private Egyptian universities and high institutes, and 218 responses were received. All participants were asked about beliefs related to wearing facemasks. For participants who taught in-person classes, compliance with and barriers to wearing facemasks at the workplace were assessed. Compliance level was classified into: Non-compliance, inadequate and adequate, based on the degree of adherence to having facemasks on and not taking them off at five main work settings. We compared demographic characteristics, beliefs, and barriers scores across compliance levels. Results Most participants (81.7%) believed that facemasks reduce infection risk to others and 74.3% believed facemasks can reduce risk to the wearer. Around 80% of the respondents who taught in-person classes wore facemasks, but only 37.8% met the criteria of adequate compliance. Difficulty breathing and impaired communication were cited as major barriers by 42.2% and 30.3% of in-person class tutors respectively. The risk of reporting COVID-19 like symptoms among non-compliant participants was double the risk among those with adequate compliance (45.9% vs 25.7% respectively). Adequate compliance was significantly associated with higher positive beliefs scores and lower barriers scores. Conclusion Adequate compliance with wearing facemasks at the workplace was low. Addressing negative beliefs may improve compliance. Difficulty breathing, and impaired communication were important barriers, therefore we recommend replacing in-person interactions with online classes whenever applicable.

Highlights • SARS-CoV-2 seroconversion in healthcare workers (100/2282) was mostly asymptomatic. • Seropositivity among this cohort tripled from 1.3% to 4.4% in 3-weeks of follow-up. • Most PCR-positive cases at baseline did not develop antibody response at follow-up. • Smell change/loss, home contact with a case or for >15 min predicted seroconversion. • Findings suggest community rather than nosocomial transmission in this cohort., Background We examined SARS-CoV-2 seroconversion incidence and its risk factors 21 days after baseline screening among healthcare workers(HCWs) in a resource-limited setting. Methods A prospective cohort study of 4040 HCWs took place between April and June 2020 at 12 university healthcare facilities in Cairo, Egypt. Follow-up exposure and clinical data were collected using an online survey. SARS-CoV-2 testing was done using rapid IgM and IgG serological tests; RT-PCR was done for those with positive serology. Cox proportional hazards modelling was used to estimate adjusted hazard ratios(HR) of seroconversion. Results Of the 3870/4040(95.8%) HCWs who tested negative for IgM, IgG, and PCR at baseline, 2282(59.0%) returned for follow-up. Seroconversion incidence (positive IgM and/or IgG) was 100/2282(4.4%,95%:CI:3.6-5.3),mostly asymptomatic(64/100,64.0%), with a daily hazard = 0.21%(95%-CI:0.17-0.25)/48746 person-days of follow-up. Seroconversion was 4.0%(64/1596;95%CI:3.1-5.1) among asymptomatic and 5.3%(36/686;95%CI:3.7-7.2) among symptomatic HCWs. Seroconversion was independently associated with older age(HR:2.71,95%CI:1.31-5.58); lower education(HR:3.89,95%CI:1.89-8.00); contact with a confirmed case>15 minutes(HR:2.20,95%CI:1.18-4.10); chronic kidney disease(HR:4.42,95%CI:1.03-18.96); pregnancy(HR:3.5,95%CI:1.05-11.85); change/loss of smell(HR:3.17,95%CI:1.48-6.78); and negatively associated with contact at workplace(HR:0.48,95%CI:0.28-0.82). Conclusions Most seroconversions were asymptomatic, emphasizing the need for regular universal testing. Seropositivity was three-fold that observed at baseline. Cumulative infections increased nationally by a similar rate, suggesting that HCWs’ infections reflect community not nosocomial transmission during the first wave of COVID-19 epidemic in Egypt.

Background The scale of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care workers (HCWs), particularly in resource-limited settings, remains unclear. To address this concern, universal (non-symptom-based) screening of HCWs was piloted to determine the proportion of SARS-CoV-2 infection and the associated epidemiological and clinical risk factors at a large public health care facility in Egypt. Methods Baseline voluntary screening of 4040 HCWs took place between 22 April and 14 May 2020 at 12 hospitals and medical centres in Cairo. Epidemiological and clinical data were collected using an online survey. All participants were tested for SARS-CoV-2 using reverse transcription polymerase chain reaction (RT-PCR) and rapid IgM and IgG serological tests. Results Of the 4040 HCWs screened, 170 [4.2%; 95% confidence interval (CI): 3.6-4.9] tested positive for SARS-CoV-2 by either of the three tests (i.e. infected); 125/170 (73.5%) tested PCR-positive. Most infected HCWs were nurses (97/170, 57.5%). Median age of infected HCWs was 31.5 [interquartile range (IQR): 27.0–41.3] years. Of infected HCWs, 78 (45.9%) reported contact with a suspected case and 47 (27.6%) reported face-to-face contact within 2 m with a confirmed case. The proportion of infection among symptomatic HCWs (n = 54/616) was 8.8% (95% CI: 6.7-11.3); 6/54 (11.1%) had fever ≥38°C and 7/54 (13.0%) reported severe symptoms. Most infected HCWs were asymptomatic (116/170, 68.2%). The proportion of infection among asymptomatic HCWs (n = 116/3424) was 3.4% (95% CI: 2.8-4.0). Conclusions The high rate of asymptomatic infections among HCWs reinforces the need for expanding universal regular testing. The infection rate among symptomatic HCWs in this study is comparable with the national rate detected through symptom-based testing. This suggests that infections among HCWs may reflect community rather than nosocomial transmission during the early phase of the COVID-19 epidemic in Egypt.

Background “Road traffic accidents” is a major health problem and it is significantly related to the mean daily sleep hours and sleep quality. This study aims to explore the sleep quality among a group of Egyptian truck drivers. Methodology A convenience sample of 117 male truck drivers working on Cairo – Suez highway was selected. Socio-demographic and occupational history were collected using an interview questionnaire and the Pittsburgh sleep quality index (PSQI) was calculated. Results The mean age of the studied drivers was 38.7 ± 9.7 y, 82.1% were married and 79.5% were current smokers. The mean driving hours per day was 15.35 ± 4.77, the mean sleeping hours per day was 5.8 ± 2.3 and 48 drivers (41%) had poor sleep quality according to the cutoff 5 for PSQI questionnaire. There was a significant difference between drivers with good vs poor sleep quality regarding number of cigarettes smoked per day, hours of work per day and mean distance travelled per day. Multivariate logistic regression showed that hours of work per day was the only significant predictor with poor sleep quality. Among drivers with poor sleep quality 16.3% reported having accidents in the past year which was significantly higher (p = 0.016) than those who had good sleep quality (2.9%), Odds Ratio: 6.4, 95% CI; 1.3-31.8. Conclusion Poor sleep quality is associate with increased risk of road traffic accidents among the studied truck drivers and the main factor that affect sleep quality is the number of working hours per day.

Introduction: As soon as the WHO declared COVID-19 a pandemic, many higher education facilities had to change their educational and teaching strategies to cope with the lockdown. Some medical schools decided to rely on online teaching while others depended on students' self-learning abilities. Methods of assessment also changed as some medical schools implemented pass/fail exams, online examinations, and research projects while others postponed their final exams. In Egypt, medical schools started delivering their lectures online and changed the assessment criteria of the preclinical academic years to depend mainly on research and online exams while postponed the clinical rotations and final exams of the clinical years. Aim: This study assesses medical students' awareness of the current situation regarding the safety guidelines and their satisfaction with the solutions provided by their schools for the plans to continue their learning and the new assessment methods and criteria. Methodology: The method used for data collection is an online survey filled by medical students from around Egypt. Moreover, data were statistically analyzed using IBM statistical package SPSS for doing a Chi-squared test on two variables. Results: After collecting the data and analyzing responses, we found that 66.2% of students who answered the survey do not think that the safety measures taken by their universities after the return back will be enough. Conclusion: This shows that the basic knowledge of COVID-19 among medical students is average and there is a need to start programs for infection control practices against COVID-19 for all medical students and professionals.